Takahashi Tohru, Kato Takuya, Mizukami Tatsuzo, Ohata Takanori, Hashimoto Taku, Abe Hironori
Dept. of General Surgery, Hokkaido Social Work Association Obihiro Hospital.
Gan To Kagaku Ryoho. 2017 Nov;44(11):1037-1040.
We herein report a case of a retroperitoneal tumor of unknown origin that was diagnosed as a seminoma after tumor biopsy and was successfully treated with chemotherapy containing bleomycin, etoposide, and cisplatin(BEP). A 47-year old man visited our hospital with left abdominal pain. An endoscopic examination revealed an ulcer lesion on the third part of the duodenum. Abdominal CT scan revealed a retroperitoneal tumor invading the abdominal aorta with the tumor thrombus in the inferior vena cava(IVC). An endoscopic biopsy could not identify the tumor's origin because of the negative staining of various surface markers on immunohistochemistry. Surgical biopsy of the unresectable retroperitoneal tumor that was finally diagnosed as a seminoma was performed. The patient was treated with BEP according to the International Germ Cell Consensus Classification(IGCCC)for risks, and orchiectomy was performed. He has been alive for 7 months with progressive shrinkage of the retroperitoneal tumor, in which 18F-fluorodeoxyglucose(FDG)positron emission tomography(PET)has shown a dramatic reduction of the maximum standardized uptake value(SUV)during chemotherapy.
我们在此报告一例起源不明的腹膜后肿瘤病例,该肿瘤经肿瘤活检诊断为精原细胞瘤,并成功接受了含博来霉素、依托泊苷和顺铂(BEP)的化疗。一名47岁男性因左腹痛就诊于我院。内镜检查发现十二指肠第三段有溃疡病变。腹部CT扫描显示腹膜后肿瘤侵犯腹主动脉,下腔静脉(IVC)有瘤栓。由于免疫组化中各种表面标志物染色阴性,内镜活检无法确定肿瘤起源。对最终诊断为精原细胞瘤的不可切除腹膜后肿瘤进行了手术活检。根据国际生殖细胞肿瘤共识分类(IGCCC)对风险的评估,患者接受了BEP治疗,并进行了睾丸切除术。他已存活7个月,腹膜后肿瘤逐渐缩小,其中18F-氟脱氧葡萄糖(FDG)正电子发射断层扫描(PET)显示化疗期间最大标准化摄取值(SUV)显著降低。